Abstracts

Clinical experience of Levetiracetam (LEV) in adults with epilepsy is growing. We therefore aimed to audit our experience of LEV in children with intractable epilepsy in the Midlands, UK.
Unselected children prescribed LEV in 2001 and 2002 were ascertained systematically from routine prospective pharmacy records or departmental patient databases. A retrospective chart review of patients using a standard proforma to assess changes in seizure frequency and adverse events was undertaken.
So far 66 patients (44 male) aged 2-17 years (mean 9 years 6 months) comprising 54.3 patient years of exposure have been studied. Mean age at onset of epilepsy was 3.4 years (2 days - 14.8 years). 37 had focal and 29 had generalised epilepsies. 65 had previously been prescribed 2 or more antiepileptic drugs (AEDs), 26 had received more than 5 AEDs. Maximum LEV doses ranged from 10 mg - 95 mg/kg/day. Duration of treatment ranged from 1 - 28 months (mean 9.9 months). 11/66 achieved LEV monotherapy.
47 (71%) had a more than 50% reduction in seizure frequency, including 14 (21%) seizure free; 8 (12%) for 6 months or more. 15 (23%) had no significant improvement, 4 (6%) had increased seizures. 10 (15%) patients reported adverse events, leading to withdrawal in 8 (12%), there were no serious adverse events.
LEV appears effective and well tolerated in a variety of intractable childhood epilepsies. Further systematic clinical audit of additional patients is underway, which we hope will allow sub-group analysis.
[Supported by: This preliminary work has received no external funding so far. We will be seeking funding to extend the data collection and analysis.]